Form 5500 · Employee benefit plan · JAMESTOWN, ND
AGRI-COVER, INC.
The filing calls this plan AGRI-COVER, INC. GROUP BENEFIT PLAN.
AGRI-COVER, INC. of JAMESTOWN, ND spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is USI INSURANCE SERVICES LLC. Coverage is written through MEDICA INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-0419401 · plan 501 · plan year 2025, filed Sep 26, 2025
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 3 insured contracts covering health, dental, vision and life; the largest, with MEDICA INSURANCE COMPANY, covers 325 people.
Reported premium across the insured contracts is $2,839,358, with $71,018 in disclosed broker commissions — about 2.5% of premium.
The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.
USI INSURANCE SERVICES LLC is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including MEDICA INSURANCE COMPANY, THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA and BENCHMARK INSURANCE COMPANY. MEDICA INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| MEDICA INSURANCE COMPANY | Health | 325 | Jun 1, 2025 | $2,626,600 | $51,707 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision, Life | 151 | Jun 1, 2025 | $184,678 | $19,311 |
| BENCHMARK INSURANCE COMPANY | Health | 135 | Jun 1, 2025 | $28,080 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 164 employees, 14 recordable cases, 8 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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